Janet Daley was born in America where she began her political life on the Left as an undergraduate at Berkeley. She moved to Britain (and to the Right) in 1965 where she spent nearly twenty years in academic life before becoming a political commentator: all factors that inform her writing on British and American policy and politicians.

Conservative party conference: How is a Tory NHS goal different to a Labour one?

Where is the Tory policy on health going? I am none the wiser after Andrew Lansley's underwhelming conference speech. He is adamant that the Conservatives will abolish the NHS target culture. Then he proceeds to set out some new targets: one year and five year cancer survival rates are to be made "at least as good" as any in Europe; in A&E there are to be reduced mortality rates after hospital admission rather than just an "arbitrary four hour target". So how is a Tory goal different from a Labour "target"?

Mr Lansley gave a couple of intriguing promises about patient choice. We will be free to choose our GPs (from anywhere in the country?) and we will have not only our choice of hospital but even of consultant. Which is fine in principle. But how is it going to work? Without some sort of payment voucher or treatment allowance, how will the patient actually take control of the assignment of surgeons or specialists to his case?

He had a fine slogan: what is needed is a tranformation of the service from "you get what you're given" to "how can we help you?", but without any description of the radical changes and new mechanisms that would be required in the delivery of care, it remains an empty aspiration.